Provider Demographics
NPI:1700981339
Name:SCHWARZ, JORGE F (DDS)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:F
Last Name:SCHWARZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SCHILL AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3353
Mailing Address - Country:US
Mailing Address - Phone:479-650-7735
Mailing Address - Fax:
Practice Address - Street 1:151 MEADOWCREST ST
Practice Address - Street 2:SUITE B
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5256
Practice Address - Country:US
Practice Address - Phone:504-394-4990
Practice Address - Fax:504-394-4903
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR35451223G0001X
LA5138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice